What do doctors really think about patients' researching their medical questions online?

Whatever ails you, a Web search can turn up health advice in a flash, from Granny’s cure-alls to research journal articles written thick with medical jargon. Somewhere in between lie consumer health sites -- WebMD, the most famous among them, and our own DukeHealth.org -- which provide broad, reliable information that is fact-checked and translated by health professionals.

These sites, in conjunction with blogs, forums, and nonprofit groups’ sites, are convenient to be sure, but they also have an unintended side effect: information overload, which can too-easily lead to patient panic.

Physician Richard Schneider, MD, says the Internet can help improve patient-physician communication, as long as it doesn’t interfere with patient-physician trust. We asked him to share a few dos and don’ts for do-it-yourself Internet medicine:

What should patients keep in mind when visiting popular consumer health sites?

Even with trusted sites, remember that the information is usually a general discussion of a particular topic -- it’s not specific to you. When patients search under particular symptoms, they can find a number of potential causes; it really is necessary to discuss your symptoms with a health care provider, who can interpret them alongside your unique health history.

One problem that I see is when patients come into the office requesting specific treatment for their own self-diagnosis, such as a rotator-cuff tear, a mini-stroke, a migraine, or lupus. Web information can be used to help determine whether you need to see your doctor, but it can’t be used to make a specific diagnosis.

What sorts of Web-based research do patients usually do?

Most of the Web-based questions I get from patients are for chronic conditions which have defied diagnosis, or for which previous treatment has been ineffective. Sometimes this information helps to allay the patients’ fears that they have a serious or life-threatening disease. Other times it creates more confusion, particularly when a patient’s research seems to indicate a particular diagnosis, but the physician doesn’t agree.

This is where the patient-doctor trust is so important. The Internet can be a tool everyone can use to improve health care, but when the Web is trusted more than the doctor, the mistrust or unwillingness to follow professional recommendations can hurt the patient.

When patients choose to do more of their own “legwork,” what’s the best way they can use their research findings?

One great thing about the availability of information online is that patients are becoming more involved in their own health care -- I think that’s something to be encouraged, particularly when it generates good questions that we can address in the office visit.

When a patient is well-informed, it often helps reinforce her physician’s recommendations; it’s easier to follow “doctor’s orders” when you understand the reasons behind them.

It’s important, though, to make sure the Web site you’re using is credible. Sometimes patients find volumes of information from unreliable Web sites, which can lead to counterproductive conversations in the doctor’s office.

Are there clues that patients can spot that might show that a Web site isn’t a good source for medical information?

When you go to a health-related Web site, if you see lots of advertisements for supplements, vitamins, and “health care” devices -- or lots of links to other sites that sell these things -- then that’s a tip that the original site is more commercial than educational.

Look for Web sites that are relatively free of commercial influences. Another helpful measure is what’s behind the “dot” -- if the site is a .org, .gov, or .edu, as opposed to a .com or a .net, then it’s more likely to be a reliable, non-commercial resource.